Idaho
Division of Occupational and Professional Licenses
Dr. GIAVONNI Mystique LEWIS
Board Of Medicine
License number
M-11927
Date granted
03/04/2013
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
DEPARTMENT OF SURGERY Salt Lake City UT 84132
idaholicensing.com
ID 48349118
LAST UPDATED 2024-03-28 20:37:19 UTC
LAST UPDATED 2024-03-28 20:37:19 UTC
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